Abstract: Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix occurs when there is a replacement of the mucosa and submucosa with fibrotic tissues. In a small community hospital, there were 195 patients that underwent appendectomy within a five-year period, in which 6.66% of patients' final pathology confirmed AO. There are some similar clinical symptoms and computed tomography (CT) findings of AO that can mimic acute appendicitis, but there is no consensus for any criteria to definitively diagnose this condition radiologically. The current method to determine the etiology of this appendiceal condition is through appendectomy followed by histological evaluation by a pathologist. We aim to analyze prior patients and their risk factors to find an alternative diagnostic method. We explore several factors including age, to determine if there can be any basis to creating a diagnostic criterion for this condition. The mean age within our case series was 58 years old. While fibrous obliteration of the appendix is a chronic inflammatory process, patients may present with acute abdominal pain, making the diagnosis difficult. Therefore, clinicians should make AO a part of their differential diagnosis which may require surgical intervention.
Abstract: Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix...Show More
Abstract: This article aims to report a rare case of a 38 years old Para 2 who was referred to the outpatient clinic of Vikash Multispecialty Hospital as a case of grade 3 uterovaginal prolapse with complaint of something coming out per vagina since 12 years. She also complained of heavy bleeding during menstruation, not responding to medical management since 2 years. Clinical and imaging studies lead to the diagnosis of anterior vaginal cyst, intramural fibroid and cervical polyp. After detailed counseling of the risks and benefits of surgical excision of the cyst with or without removal of uterus, she opted for removal of vaginal cyst and vaginal hysterectomy as she was tired of the medical management and had to undergo blood transfusion twice due to heavy menstrual bleeding. She had an uneventful postoperative period and was discharged in good condition on the third day. This case stresses on the importance of right diagnosis and proper management of the masses coming out of vagina as not everything which comes out of vagina is prolapse. Hesitancy in seeking medical care and lack of proper medical facilities, especially in rural areas in underdeveloped and developing countries, are among the major reasons these cases are unreported in medical literature.
Abstract: This article aims to report a rare case of a 38 years old Para 2 who was referred to the outpatient clinic of Vikash Multispecialty Hospital as a case of grade 3 uterovaginal prolapse with complaint of something coming out per vagina since 12 years. She also complained of heavy bleeding during menstruation, not responding to medical management sinc...Show More